You might be exploring sleep treatments if you're not getting the quality or quantity of sleep that you need to function and stay healthy. Your treatment options will vary depending on whether insomnia or snoring wake you in the night, if you're dozing off mid-day, or if your sleep cycles have shifted due to work or travel.
If an underlying condition - like pain, anxiety, depression, nasal allergies, or heartburn - disrupts your sleep, you'll want to deal with that first. And surgery may be a "last resort approach" in the most severe cases of sleep problems due to snoring or sleep apnea. But in most cases, treatments for sleep problems fall into a few main categories:
- Lifestyle changes for better sleep
- Improvement of sleep hygiene
- Sleep medications, supplements, and natural products
- Sleep-assistive devices
- Behavioural therapy
What you do when you're not in bed can have a direct impact on what happens when your head hits the pillow.
- Lose excess weight. Extra pounds mean extra pressure on your airways, which can make you vulnerable to 2 big sleep disruptors: snoring and sleep apnea.
- Reduce caffeine consumption. Caffeine is a stimulant, so it may interfere with your body's ability to calm down and settle in for sleep. Watch for caffeine in coffee, tea, soft drinks, chocolate, and in other food and beverages.
- Quit smoking. Like caffeine, the nicotine in cigarettes is a stimulant and could complicate the process of getting to sleep. And since smokers cannot smoke in their sleep, symptoms of nicotine withdrawal may also wake up smokers throughout the night.
- Avoid alcohol. Some people use alcohol to "self-medicate" their insomnia. And though increased blood alcohol levels can make a person feel drowsy, falling levels of alcohol a few hours later can have a stimulating effect that interrupts sleep.
- Change your work schedule. Non-traditional work schedules - night or graveyard shifts, swing or double shifts - can disrupt normal sleep patterns and lead to shift work sleep disorder . If possible, ask your employer for the option of adjusting your work schedule.
Your bedtime habits and bedroom environment affect how easily you fall asleep and how soundly you keep snoozing.
- Schedule your sleep. Set yourself a "bedtime," like you would for a child. Going to bed and getting up at roughly the same time each night and day can help to normalize your sleep habits and encourage sleepiness and wakefulness at reasonable hours. And just like story time or lullabies prepare children to sleep, follow your own bedtime rituals (e.g., having a warm bath, reading) to set the "sleepy mood."
- Save your bed for sleep. This means not using the bed as a desk or a place to lounge and watch television. And this also means not remaining in bed if you struggle to fall asleep. If you do not fall asleep within 20 minutes, get up and do something else until you are sleepy enough.
- Change your sleep position. Are you a side sleeper, a belly-dozer, or do you dream best on your back? Certain positions may be better depending on your health and physical condition. Sleeping on your back may increase your risk of snoring. Sleeping on your stomach can lead to neck and back pain. To prevent pain, try to sleep in a position that lets you keep the natural curve in your back.
- Strategically time your meals and workouts. Regular physical activity and a healthy diet support good sleep. But lying down too soon after eating can cause heartburn or indigestion. And exercise kick-starts your mind and muscles and increases your heart rate and body temperature - all of which work against sleep. If possible, schedule exercise in the morning or early afternoon hours.
- Set up your bedroom for maximum sleep potential. Your bedroom environment can affect your ability to fall asleep and stay asleep. For one thing, it's easier to get to sleep when your bedroom is on the cooler side. That's because a cooler climate - between 12 to 24 degrees Celsius (54 to 75 degrees Fahrenheit) - is similar to the climate inside of your body when you sleep. Also, keep your bedroom as dark as possible. Bright light can interfere with your brain's release of the sleep-inducing hormone called melatonin.
Talk to your doctor before trying sleep medications or supplements. Some sleep aids are only available by prescription and, in general, should only be used short term. Be advised that side effects can occur with any type of medication, and interactions are possible between sleeping aids and your other medications. Dependence is also an issue with some kinds of sleep medications.
Sleep medications, or more commonly, "sleeping pills," encompasses several categories of medication. Your choice of sleep medication may differ depending on the nature of your sleep difficulty. Some sleep medications assist with falling asleep and others with staying asleep. Medications that may be taken or prescribed to help with sleep include:
- Benzodiazepines: Only available by prescription, benzodiazepines can help make it easier to fall asleep or stay asleep, depending on which one is used and how it's taken. Not all benzodiazepines are used for sleep. Some benzodiazepines prescribed for sleep include nitrazepam and temazepam.
- Hypnotic-sedatives: Similar to benzodiazepines, this class of medications calm the central nervous system and encourage sleep. Examples of hypnotic-sedatives are zopiclone and zolpidem. Chloral hydrate is another hypnotic-sedative that is rarely used today because it loses effectiveness after about two weeks and is associated with many interactions with other medications.
Diphenhydramine is a non-prescription antihistamine product used to treat allergies that also happens to have a sedative effect. It is not the best medication to take for sleeping problems, especially for seniors. For some people, it may be appropriate to take occasionally for difficulty sleeping, but talk to your doctor of pharmacist before taking it. If you find you need to use this more than once or twice a week, consider seeing your doctor or health care provider for other options to help you sleep.
Central nervous system stimulants are prescribed if it is a wakefulness disorder that disturbs your sleep, like narcolepsy or excessive daytime sleepiness, a stimulant may help you to stay alert and awake during the day. Examples of this kind of medication include modafinil, dextroamphetamine, and methylphenidate.
Melatonin is a hormone produced in the brain that sends your body a natural "time-to-sleep" signal. But things like jet lag and shift work can disturb this natural sleep-wake cycle (circadian rhythm). Taking a supplement of melatonin may help the body get back into its normal sleep-wake cycle. Speak to your doctor before taking melatonin and be sure that the product you buy has a natural health product (NHP) number. This will ensure that the product is of high quality. Read more about melatonin in our natural health products database.
L-tryptophan is an amino acid that is a main ingredient in several natural health products used to help with sleep problems. Currently, there is not enough evidence to show that it is effective as a sleep aid; although some studies have shown that it might decrease the amount of time it takes to fall asleep.
Valerian extracts have long been used to treat sleep disorders and anxiety. People take valerian in liquid or pill form or as a tea. And while the natural product is relatively safe, it has not been shown to be consistently effective as a sleep aid. Some studies have shown no benefit compared to a placebo (i.e., sugar pill) and others have only shown a modest benefit. Read more about valerian in our natural health products database.
Sleep-assistive devices may provide the extra boost or support you need to get a better night's sleep.
- Light therapy devices: Daylight and darkness play such important roles in the regulation of our sleep-wake cycles. And for those with circadian rhythm sleep disorders, light can be a powerful tool to help reset or realign out of synch sleep-wake cycles - especially during the darker months of winter. A light box, desk lamp, light visor, or dawn simulator can be used to provide a steady, intense, but safe amount of light exposure to those who need it. For more information, read how light therapy is used to treat seasonal affective disorder.
- Continuous positive airway pressure (CPAP): CPAP is a device used by people with sleep apnea or severe snoring who experience pauses in breathing as they sleep. A mask worn on the face during sleep blows a gentle stream of air into the back of the throat to maintain a clear airway.
- Dental mouth guards: Like CPAP, these oral appliances are worn during sleep to keep the airway open and prevent episodes of snoring and sleep apnea. Ask your doctor or dentist about getting a custom-fitted mouth guard, which would be more effective than a store-bought appliance like a sports mouth guard.
Therapy may help you to deal with the anxiety, depression, or negative thoughts that interfere with sleep.
- Cognitive therapy: The aim of cognitive therapy is to root out and become better equipped to handle the underlying beliefs and causes of sleep problems. In cognitive therapy, you might learn more about sleep hygiene or try out techniques like sleep restriction, biofeedback, stimulus control, and relaxation training.